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Saturday, August 22, 2015

Just some ramblings about where we've come from, and the dangers ahead.

As some of you may be aware, I've started a new (daytime) job. I'm the new Facility Medical Director of the hospitalist program in McAlester, OK. And why would I now, this close to retirement, start something as foolish as a new job? Well, that's the key - I'm inching ever so close to retirement that I really wanted to make a difference. And that was just not going to happen where I was. I was yet another cog in the industrial machine of medicine.

McAlester is kind of an interesting town, and reminds me a lot of Chickasha, OK, where I spent six years in the practice of medicine. And the hospital in McAlester is a regional hospital in Southeast Oklahoma. As with most hospitals in this day, it is facing a future which is uncertain, somewhat dangerous, and certain to cause tremendous change in the way medical care is dispensed. And what of the physicians, and in particular the physicians who serve the hospital and its patients? What are the challenges that these physicians are facing?

There are two major challenges which I see facing the physicians in our increasingly uncertain world of the next few (or many) years. The first is one of definition, and the second is one of adaptation.

By definition, I mean how is it that we tell ourselves why we do what do. It has been my contention that physicians are not quite like anyone else. Historically, physicians have held a special place within the ranks of humanity. As far back as the ancient Greeks, and the healers and shamans of tribal peoples physicians or healers have been seen as persons set apart. And it is a special calling that we as physicians feel. It is more than just a job, it becomes in a very real way part of how we define ourselves, and see ourselves.

William Osler put it this way (and here I must thank Janice Mancuso, creator of The Osler Symposium for this quotation).
     "You are in this profession as a calling, not a business: as a calling which extracts from you at               every turn self-sacrifice, devotion, love and tenderness to your fellow men. Once you get down to a purely business level, your influence is gone, and the true light of your life is dimmed. You must work in the missionary spirit, with a breadth of charity that raises you far above the petty jealousies of life."

What we, as a profession are facing is the redefinition of ourselves as something easily replaceable, easily expendable, and oh, so easily missed. And I, for one, object!

By adaptation, I see physicians, as humans, needing to adjust our lives in such ways that we can regroup and refresh ourselves in concert with the demands of the institutions which employ us, or have power over us. For the institutions do not care, and if we do not adapt, we will burn out.

So, you see, I've got an agenda, albeit a nebulous one, which I've set for myself. And whatever you think of it, my other profession as a writer keeps me going - at least for now.

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